INTERMOUNTAIN DIAGNOSTICS, INC. (NPI# 1154429058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154429058 |
| Entity Type | Organization |
| Organization Name | INTERMOUNTAIN DIAGNOSTICS, INC. |
| Practice Address |
200 N 4th St Suite 15 Boise ID 83702-6001 |
| Practice Telephone | 2083310436 |
| Practice Fax Number | 2084248501 |
| Mailing Telephone | 2083310436 |
| Mailing Fax Number | 2084248501 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | L. KATHLEEN CAMMACK (BILLING AGENT) |
| Authorized Official Telephone | 2083374254 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246XS1301X |
Spec/Tech, Cardiovascular Specialization: Sonography |
NONE GIVEN IN ID | ID | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD | 000010017912 | 01 |
| ID | UNITED MINE WORKERS | 1538377 | 01 |
| ID | OMAP (OREGON MEDICAL) | 170283 | 01 |
| ID | BLUE CROSS | 8D244 | 01 |
| Street Address |
200 N 4TH ST SUITE 15 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659334944 | Marlys Ann Borreson | Counselor | 200 N 4th St, Suite 205b, Boise, ID 83702-6001 | 2006-04-08 |
| 1285176669 | David Mcelwain | Acupuncturist | 200 N 4th St, Suite 15, Boise, ID 83702-6001 | 2016-11-16 |
| 1558304923 | Intermountain Diagnostics Inc. | Spec/Tech, Cardiovascular | 200 N 4th St, Suite 15, Boise, ID 83702-6001 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 246XS1301X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Cardiovascular |
| Specialization | Sonography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558304923 | Intermountain Diagnostics Inc. | Spec/Tech, Cardiovascular | 200 N 4th St, Suite 15, Boise, ID 83702-6001 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205274677 | Leah Caroline Godsey | Spec/Tech, Cardiovascular | 2001 S Woodruff Ave Ste 12b, Idaho Falls, ID 83404-6372 | 2013-06-07 |
| 1366422248 | Sandcreek Echo, Inc. | Spec/Tech, Cardiovascular | 2050 E 25th St, Idaho Falls, ID 83404-6490 | 2006-01-18 |
| 1609263482 | Chad Steven Dahle | Spec/Tech, Cardiovascular | 2001 S Woodruff Ave, Suite 12 B, Idaho Falls, ID 83404-6374 | 2015-04-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.